A new health care threat to N.C. children and families

Sarah Cameron holds up a photo of her two sons as she talks about CHIP during a news conference this month in Pittsburgh.
Sarah Cameron holds up a photo of her two sons as she talks about CHIP during a news conference this month in Pittsburgh. AP

Do you support quality health care that saves money and promotes employment? Lost in the clamor around the tax bill, two issues before Congress would do just that.

They are the renewal of funding for both the Children’s Health Insurance Program (CHIP) and Community Health Centers. Both have been held hostage for months by Congressional inaction.

Created in 1997 with bipartisan support, CHIP insures 9 million children with family incomes too high for Medicaid and who lack other insurance. They receive comprehensive coverage including developmental screening and services allowing special-needs children to stay in their homes rather than institutions. Average spending per child is 40 percent lower than employer-based care. Receiving CHIP enhances the medical and financial security of these working families. The federal funding for CHIP expired on Sept. 30, and while states have scrambled to cover the loss, almost every state will run out of funding by early 2018.

Jessica Schorr Saxe

Community health centers care for over 27 million Americans. According a report from the National Association of Community Health Centers, most patients nationally are low income, with 71 percent below the federal poverty level. Many have chronic diseases. Yet the quality health measures of community health centers are higher than private practices, with more preventive screenings and more appropriate use of medications. Good chronic disease management enables the employed to work more effectively and the disabled to live with less distress (and less expense to the state). The cost of care is relatively low, saving $1,263 per patient per year through lower spending for emergency, hospital, and outpatient care and on medications.

In 2016, community health centers in North Carolina served 500,000 patients at 220 sites in 81 counties. They operate on sliding scales, based on patients’ ability to pay. In N.C., 43 percent of patients are uninsured, compared to the national average of 24 percent, making our centers among the most vulnerable to funding loss.

Health centers faced a funding cliff back in September, meaning Congress had to enact legislation to continue funding, which they failed to do. If Congress doesn’t fix the cliff, 115,000 N.C. patients are at risk of losing access to care.

These centers rely on doctors who get help with loan repayment for their medical educations through the National Health Service Corps. Already affected by the funding instability, some have left.

If CHIP or community health centers funding is lost, patients who lose access to their primary care providers will either skip needed care or may end up in emergency rooms. That care, less effective for routine childhood care or chronic diseases, will still be picked up by taxpayers but at greater expense.

Call your Senators at 202-224-3121 now and tell them to provide sustained, predictable funding for CHIP and community health centers that does not come at the expense of other desperately needed health programs.

Jessica Schorr Saxe, MD, is a family physician in Charlotte who chairs Health Care Justice—NC. Contact her at